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Open Access 01-12-2024 | Bronchial Asthma | Research

Real-world association between systemic corticosteroid exposure and complications in US patients with severe asthma

Authors: Thomas B Casale, Thomas Corbridge, Guillaume Germain, François Laliberté, Sean D MacKnight, Julien Boudreau, Mei S Duh, Arijita Deb

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2024

Abstract

Background

Systemic corticosteroid (SCS) use remains widespread among patients with severe asthma, despite associated complications.

Objective

Evaluate the association between cumulative SCS exposure and SCS-related complications in severe asthma.

Methods

This retrospective, longitudinal study used claims data from the Optum Clinformatics Data Mart database (GSK ID: 214469). Eligible patients (≥ 12 years old) had an asthma diagnosis and were divided into two cohorts: SCS use and non/burst-SCS use. Patients in the SCS use cohort had a claim for a daily prednisone-equivalent dose ≥ 5 mg SCS following ≥ 6 months of continuous SCS use; those in the non/burst-SCS cohort had no evidence of continuous SCS use and had a non-SCS controller/rescue medication initiation claim. For each cohort, the date of the qualifying claim was the index date. SCS users were further stratified by SCS use during each quarter of follow-up: low (≤ 6 mg/day), medium (> 6–12 mg/day), high (> 12 mg/day), and continuous high (≥ 20 mg/day for 90 days). SCS-related complications were evaluated in the quarter following SCS exposure. The adjusted odds ratios (OR) of experiencing SCS-related complications during follow-up in each of the SCS use groups versus the non/burst SCS cohort were calculated using generalized estimating equations models.

Results

SCS and non/burst-SCS use cohorts included 7473 and 89,281 patients (mean follow-up: 24.6 and 24.2 months), respectively. Compared with the non/burst-SCS use cohort, medium, high, and continuous high SCS use was associated with greater odds of any SCS-related complication (adjusted OR [95% confidence interval]: 1.30 [1.21, 1.39], 1.49 [1.35, 1.64] and 1.63 [1.40, 1.89], respectively) including increased acute gastrointestinal, cardiovascular, and immune system-related complications, and chronic cardiovascular, metabolic/endocrine, central nervous system, bone-/muscle-related, ophthalmologic, and hematologic/oncologic complications. Low-dose SCS use was also associated with significantly increased odds of acute gastrointestinal and immune system-related complications, and chronic bone-/muscle-related and hematologic/oncologic complications versus the non/burst-SCS use cohort.

Conclusion

SCS use, even at low doses, is associated with increased risk of SCS-related complications among patients with severe asthma.

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Title: Real-world association between systemic corticosteroid exposure and complications in US patients with severe asthma
Authors: Thomas B Casale
Thomas Corbridge
Guillaume Germain
François Laliberté
Sean D MacKnight
Julien Boudreau
Mei S Duh
Arijita Deb
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Bronchial Asthma
Published in: Allergy, Asthma & Clinical Immunology / Issue 1/2024
Electronic ISSN: 1710-1492
DOI: https://doi.org/10.1186/s13223-024-00882-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Real-world association between systemic corticosteroid exposure and complications in US patients with severe asthma

Abstract

Background

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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